Receiving VA Disability for Prostate Cancer
Published January 27, 2023
Are you a veteran who has been diagnosed with prostate cancer? Did you serve in the Vietnam War or have other reasons to believe your cancer is connected to your military service?
This article explains some basics of how the VA looks at prostate cancer, how it rates it, and what you can do to obtain benefits or increase your VA disability rating relating to prostate cancer.
The VA Disability Rating process
Granting of VA disability benefits begins with the veteran filing a claim with the VA. Lawyers are usually not involved in this initial step because federal law prohibits anyone from charging a veteran for assisting them in filing an initial claim. However, there are local VSOs (veteran service officers) trained to assist veterans in preparing the necessary paperwork.
The VA will then review the submitted paperwork, such as service records and medical records, may ask for more information, and often will also set up a C&P exam (Compensation & Pension Examination) for a medical professional to examine the veteran and either collect or verify information necessary for a claims determination.
Assuming the VA agrees that the veteran has a current disability and qualifying military service and finds a nexus or connection between the two, the VA will then proceed to assign a rating number to each disability claim (sometimes a veteran has multiple conditions being evaluated). A disability rating will be a number between 0% and 100% (increments of 10).
The VA’s process of assigning a percentage number to each granted disability claim is based upon detailed federal law and regulations, comparing a diagnosis, symptoms, and treatment against various ratings schedules. This rating number, whether for an individual disability or compiled together to reach a combined or overall VA disability rating, determines the dollar amount of monthly benefits.
VA disability rating disputes are handled as appeals. If you disagree with the VA’s rating decision, you have the option to appeal. Veterans frequently can get an increased VA disability rating if the VA made a mistake. Frequently the VA makes a ratings decision on a veteran’s claim that the veteran disagrees with. These underratings (a rating decision that appears to be lower than it should be) are frequently appealed and often successful. If you want to increase your VA disability rating, you will likely want to hire an experienced VA disability attorney to assist you.
Is my Prostate Cancer caused by military service?
Prostate cancer is presumptively connected to military service for Vietnam War-era veterans who were exposed to Agent Orange. What that means is that the VA has in place a list of geographical areas and military service time frames where veterans were presumed to have been exposed to Agent Orange. For those places and times, if you served in any of those locations and later are diagnosed with certain illnesses, the VA will assume that a connection exists between your service and the illness. Prostate cancer is one of those presumptive conditions.
Being able to claim a presumption of service connection can simplify and shorten the process for getting your VA disability claim approved. It is also possible that prostate cancer could be connected to other military service, but it will require a medical opinion to make the connection between service and the development of cancer.
What should you expect monetarily for prostate cancer?
The tax-free VA disability benefit payments you may get if your VA disability claim is approved will be determined based on your VA disability rating percentage. If your only disability rating is for prostate cancer, that will be the rating percentage used to determine monthly payments. However, if you have multiple disability conditions (as many veterans do), the VA combines them by a specific formula into an overall combined VA disability rating on a scale of 0% to 100%, and that percentage, along with your family composition for ratings 30% or higher, will determine your payment amount.
For prostate cancer, the VA first looks at whether your tumor is benign or malignant. If it is malignant, the rating will be 100% initially but is subject to a mandatory VA examination at the end of six months. If the tumor is benign, the VA will rate your condition based upon “residual conditions” which basically means other related conditions that are related either to the cancer itself or the cancer treatment you are receiving.
As noted above, if you get a 100% rating for your active malignant cancer, the VA will require a follow-up examination six months later, and, assuming your treatment is going well, perhaps you are cancer free at that point, your VA disability rating number will likely go down from the 100%. When this happens you will be rated on the residuals of your prostate cancer, most commonly it will be rated based on voiding frequency. If the cancer comes back, you may go back up to the 100% rating.
Can you receive TDIU for prostate cancer?
Yes, you can receive TDIU (temporary disability individual unemployability) if you meet the general requirements for TDIU. You can claim TDIU if you have a single service-connected VA disability rating of 60% or higher, or a combined service-connected VA disability rating of 70% or higher, AND that as a result of this disability you are unable to maintain regular, gainful employment. Obviously, active prostate cancer would meet the percentage requirements, but you also need to demonstrate the inability to maintain regular, gainful employment, which is basically work at or below the federal poverty level which is around $12,000/yr in work income.
Read more about TDIU here.
How can you appeal your VA Disability rating?
Yes, you can file a VA disability appeal within one year of your Rating Decision. There are three different types of appeals available to you within the VA claim appeals process – Higher Level Review (same file information, but more experienced reviewer at the VA), Supplemental Review (provide new, relevant information that may change the decision), or Board Review (have a live hearing before a judge). Each type of appeal can be useful depending on the issues you want to appeal. An experienced VA disability attorney can help you sort out what type of appeal makes the most sense for the specific details of your case. VA disability claim attorneys have done hundreds, if not thousands, of cases similar to yours, and tapping into that expertise may increase your odds of getting the outcome you desire from the VA.
Have you received an adverse decision on your probate cancer VA disability claim with the VA? Would you like a free review of your case? For over 25 years Veteran’s Law Group has helped veterans like you navigate the VA disability process after an initial rating decision has been issued, often helping you obtain the maximum VA disability benefits you are entitled to receive.